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South Dakota rates for HCPCS Q4252

Vendaje, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.00 / $53.00 / $53.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.00 / $53.00 / $53.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,210.50 / $1,210.50 / $1,513.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.21 / $90.10 / $111.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.00 / $89.57 / $145.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.00 / $53.00 / $1,288.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.60 / $115.45 / $407.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.60 / $115.45 / $407.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.00 / $58.00 / $58.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.00 / $53.00 / $58.30
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.00 / $53.00 / $53.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.00 / $53.00 / $53.00